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New York Plastic Surgery

Labiaplasty New York City

Choosing a Labiaplasty (labia surgery)

Labiaplasty typically refers to the surgical reduction of the size of the labia minora, however it can also be performed to reduce the size of the labia majora. For women seeking rejuvenation of the area, the labia majora can also be augmented as they tend to atrophy or deflate with aging or weight loss.

Women tend to seek labiaplasty for a variety of reasons. Most commonly, it is sought for aesthetic purposes. Some women feel uncomfortable about the size of their labia when they are disrobed but they may feel self-conscious even when they are clothed if bulging occurs due to the size of the labia. Self-consciousness is typically experienced when garments that are worn are form fitting, such as exercise clothes or bathing suits. In addition, enlarged (or hypertrophic) labia can be responsible for pain or discomfort during intercourse, can cause recurrent urinary tract infections, can interfere with sports and cause difficulties with cleanliness and hygiene. Any combination of these things can cause significant emotional stress for women.

Labiaplasty surgery can reduce the size of the labia minora (and majora if desired) to alleviate any or all of the problems that women experience as a result of having enlarged labia.

Am I a good candidate for a labiaplasty?

You are considered to be a good candidate for labiaplasty if you are unhappy with the large size of your labia. You should be in relatively good health, live in New York City (or be willing to travel), and be motivated to follow Dr. Cangello’s pre-operative and post-operative instructions. This includes abstaining from sexual activity and tampon use (feminine pads can be used) while you are healing from surgery.

You may wish to consider labiaplasty if you experience any issues related to the large size of the labia. These issues include: pain during intercourse or other physical activity, discomfort while wearing certain clothes, psychosocial unease do to your appearance or if you have hygiene related issues due to the size of the labia.

Labiaplasty is available to women and girls who have reached sexual maturity. Pubertal development can cause excessive growth of the labia at a young age. Having large labia can cause severe social discomfort and anxiety for young women and girls. Good candidates range from; young teenagers around the age of 15 whose labial size hinders their physical activity in athletic endeavors or causes them social anxiety when disrobed in changing areas to older women who have similar issues or who seek rejuvenation of the vulva after their reproductive years.

Good candidates must also have realistic expectations for the surgery. Women who experience pain or discomfort during intercourse or with physical activity can likely expect to have relief of those issues. By reducing the size of the inner labia to the point where they are hidden within the labia majora women can also expect to alleviate hygiene related issues and also to feel much better about their physical appearance. Dr. Cangello will explain the results that you can expect from the labiaplasty and may suggest additional procedures to achieve your desired look. Additional procedures could include fat grafting to the labia majora in women who have lost volume in this area as they age. Alternatively, some women also have excessively large labia majora and they may want to have them reduced in size as well.

The Consultation: Creating Your Plastic Surgery Plan

Your process to have labiaplasty surgery begins with a consultation with Dr. David Cangello in our New York City office located in Tribeca. Dr. Cangello will discuss your medical history and the results that you would like to achieve from your labia surgery. Your goals will likely include reduction of the size of the labia minora and/or majora and for some women, rejuvenation of the labia majora if they appear deflated. For your surgery to proceed safely, you need to be honest about your allergies, medications, personal habits, and previous surgical procedures.

Dr. Cangello will ask about your goals for the labiaplasty and the look you hope to achieve. He will conduct a physical examination, so he can see the extent of labial hypertrophy (overgrowth) and whether it involves the labia minora or majora only or both. He will also determine if the labia majora appear atrophied and if they could benefit from “refilling” with fat grafting. Following the physical exam, Dr. Cangello will explain how labiaplasty can improve the external appearance of the vagina and surrounding tissues. Dr. Cangello can also describe additional surgical solutions that can be combined with labiaplasty as necessary.

Labiaplasty is not a procedure where one approach fits all. In fact, the key to a good outcome is having a surgeon who can properly assess the anatomy and determine how it differs from what is considered to be “normal”. This is where the skill of an experienced, artistically inclined board certified plastic surgeon is essential.
Dr. Cangello will recommend a surgical plan that will help create the appearance of the outer aspect of the genitalia that you desire. He will also answer your questions and explain how to prepare for your procedure.

Preparing For Your Labiaplasty

Dr. Cangello is committed to achieving the best results possible. During your initial consultation, he will create a pre-operative plan for you to follow. This plan is designed for your unique needs, to make sure that you have the best outcome possible. Your pre-op plan may include changes in diet and other habits that impact your health. If you are a smoker you will be asked to stop smoking.

Dr. Cangello will also give you instructions for the days before your surgery. These include stopping certain medications and supplements that may cause thinning of the blood which can lead to bleeding after surgery. You will also be instructed not to eat beginning at midnight on the day of your surgery if you are going to be put to sleep during your procedure.

Finally, Dr. Cangello and his staff will explain your post-operative plan. He will give you prescriptions to fill prior to surgery and ask you to find someone to accompany you home following surgery (if you are put to sleep). You should not shave the pubic hair immediately before surgery.

Where will the surgery be performed?

The labiaplasty surgery is performed in Dr. Cangello’s AAAASF approved operating room on site in his office. The facility is state of the art and is equipped with all of the essential medical equipment to ensure that your procedure is extremely safe. Your safety is of utmost concern to Dr. Cangello. In the event of an emergency, Dr. Cangello has admitting privileges at both New York Presbyterian Hospital and Lenox Hill Hospital.

Types of Anesthesia

The type of anesthesia used depends on the extent of your procedure, your tolerance for minor discomfort and also on your anxiety level while having a procedure. Often the procedure can be done with local anesthetic only. When local anesthetic is used, the only discomfort that is experienced by the patient is the slight burning sensation that occurs as the numbing medicine is injected. Dr. Cangello uses a topical anesthetic prior to injection of the local so that the pinch of the needle is not felt. The discomfort from the numbing medicine being injected is very brief and no pain is felt during the actual procedure. Oral medication can also be given to reduce anxiety.

While general anesthesia is not necessary for the procedure, intravenous sedation can be used so that the patient sleeps through the procedure and experiences no discomfort at all. Dr. Cangello works with only highly experienced Board Certified anesthesiologists that he has worked with for years. Local anesthetic is used in conjunction with intravenous sedation. If the patient choses to have sedation she must plan to be accompanied home from the procedure by a responsible adult.

Labiaplasty Surgery Techniques

The two most common techniques of labiaplasty include the “trim” technique and the “wedge” technique. Dr. Cangello prefers the latter “wedge” technique in most instances.

Trim Technique
The Trim technique essentially is an amputation of the labia minora. From a technical standpoint this is the easiest method for reducing the size of the labia minora. As seen in the illustration below, the excess labial tissue is excised along the full length of the rim of the labia minora. The benefit of this type of labiaplasty is that it is more easily executed by the surgeon and potentially takes less time. However, the downside is that the pigmented edge of the labia is lost which in some cases can result in an unnatural appearance. A visible scar may also be seen since it is located on the rim (or outer edge) of the labia. However the tissues in this area heal exceptionally well so visible scarring is not of great concern. The Trim technique is best suited for women with minimal labial hypertrophy (excess growth).

Photos courtesy of medscape

The Wedge Technique
In contrast to the Trim technique, where therimof the labia minora is amputated, a wedge of the labia is removed. The advantage of this technique is that the pigmented color of the labial rim is maintained. The appearance of scars is really not an issue as the tissue in this area heals exceptionally well. The wedge can be designed in one of many ways depending on the shape and size of the patient’s labia. Options include excision of a central wedge of tissue, an anterior wedge, a posterior wedge or a combination of the two. All of these types of excision maintain the color of the labial rim, which is usually pigmented, unlike the inner part of the labia which is pink.

Photos courtesy of medscape

Labia Majora
The labia majora can also be treated depending on the aesthetic issue. Excessively large labia majora can be treated by excision. A crescent of the inner aspect of the labia majora is excised, leaving the scar hidden deep in the fold at the junction between the labia majora and labia minora. The placement of the scar can be seen in the diagram below and it is located where the straight vertical black line is drawn. Another aesthetic concern that arises for women is that the labia majora can appear deflated. This commonly occurs after the reproductive years or after significant weight loss, but can happen at any time. Treatment for this involves adding 10- 15 cc of fat by grafting the fat suctioned from another area of the body to the labia majora.

Photos courtesy of medscape

The Recovery Process

When your labia surgery is complete you will have sutures (stitches) in the area that was operated on. You will also have antibiotic ointment on the incisions and a sterile dressing covering the incisions. If you had Intravenous anesthesia for your procedure, you will need to be accompanied home from Dr. Cangello’s office. However, because this procedure can be a highly sensitive procedure for some, it can be done under local anesthesia only. If your procedure is done under local only, you do not need to have someone accompany you home.

A prescription for pain medicine will be given to you prior to your procedure and you may take that as needed. You are asked to avoid medicines containing Ibuprofen or Aspirin after surgery until Dr. Cangello gives permission for their use.

Your dressing should be removed before you use the toilet and you should gently cleanse the area with light soap and water after you use the toilet. The area should be pat dry with a clean towel and the dressing should be replaced with new ones. You are permitted to shower (not bathe) 48 hours after the procedure.

A feminine pad can be used, however tampons should be avoided for 4 (four) weeks. Sexual intercourse and self-stimulation should be avoided for 4 weeks. You may return to work the following day after surgery, provided you are comfortable.

Please call our New York City office at 212-644-4416 to set up a consultation and learn how you can benefit from vaginoplasty / labiaplasty (labia surgery).